心搏骤停猪复苏前后心电图的变化  

Changes of Electrocardiogram in Cardiac Arrest Pig during Cardiopulmonary Resuscitation

作　　者：代正[1] 周军荣[2] 张维[3] 刘亚华[4] 张杰[4] 周满红[1] 沈洪[1] 

机构地区：[1]中国人民解放军总医院急诊科,北京市100853 [2]中国人民解放军总医院心内科,北京市100853 [3]中国人民解放军总医院总后司令部管理保障局第一门诊部,北京市100853 [4]北京市武警总医院

出　　处：《中国全科医学》2012年第14期1650-1652,共3页Chinese General Practice

摘　　要：目的分析心搏骤停家猪心肺复苏前后体表心电图的变化,确认其为判断复苏后心脏损害的依据。方法采用健康雄性家猪19头,体质量(25.5±0.7)kg,麻醉后制备电刺激法心搏骤停心室纤颤模型,9 min后行心肺复苏术,复苏过程中对停搏前、自主循环恢复(ROSC)即刻、复苏后24 h进行12导联心电图监测并分析。结果ROSC使心率增快并出现再灌注性心律失常。与停搏前相比,ROSC即刻的心率明显增快,QT间期明显缩短,并可见明显T波改变以及S-T段下降,且两时点间的差异有统计学意义(P<0.05)。复苏24 h时心率与QT间期恢复,但仍存在T波改变与S-T段下降。结论体表心电图是监测心肺复苏前后心脏损伤变化的基本依据,特别是T波、S-T段改变反映了复苏后心脏供血与功能的改变。Objective To investigate the changes of electrocardiogram during the cardiac arrest（CA）and cardiopulmonary resuscitation（CPR）,and attempt to confirm it as the evidence of the myocardium damage in CPR.Methods 19 domestic pigs,male,weighing（25.5±0.7）kg,were anaesthetized.The model of cardiac arrest（CA） ventricular fibrillation（VF） was induced by electrical stimulation instruments.After 9 minutes untreated VF,standard CPR was done.In this process,the 12 lead of electrocardiogram was measured and recorded at the following time point：pre-cardiac arrest,ROSC and post-resuscitation 24 h.Results ROSC resulted in the increased heart rate and appearance of reperfusion arrhythmia.Compared with that pre-cardiac arrest,the heart rate at the time of ROSC was increased obviously,QT interval was decreased obviously,the T wave changes and S-T segment depression were observed,and there were significant differences between two time points（P0.05）.In post-resuscitation 24 h,the heart rate and QT interval were recovered,but the T wave changes and S-T segment depression were still existed.Conclusion The surface electrocardiogram can be an essential evidence of monitoring the changes of the myocardium damage during the cardiac arrest and cardiopulmonary resuscitation and the changes of T wave and S-T segment can better reflect the blood supply and functional of heart in post-cardiopulmonary resuscitation.

关 键 词：心电描记术 猪 家养 心肺复苏术 心搏骤停 

分 类 号：R541.78[医药卫生—心血管疾病]